Clinical Markers of Cholestetoma

Objective: to evaluate the significance of clinical markers,predict underlying cholestetoma in chronic suppurative otitis media. study design: it is cross-sectional descriptive study. place & duration: this study conducted at ent department liaquat national hospital karachi from june 2003 to july 2005. material & methods: patients presented with history of chronic suppurative otitis media with clinical markers,suspicious of underlying cholestetoma irrespective of age and sex were evaluated by detailed history,otolaryngology examination,ear examination under microscope,hearing loss assessment primarily by tuning fork test and pure tone audiometry. all patients were operated for mastoid exploration by cortical mastoidectomy and then subsequently converted into modified or radical mastoidectomy according to nature and extent of disease. tissue removed sent for histopathology to confirm the diagnosis results: out of 100 patients 48 were females and 52 were males. fifty-six of patients had nonspecific chronic inflammation and 44% had cholestetoma. highest prevalence of cholestetoma observed in aural polyps (31.81%),followed by 27.27% in chronic discharging ear with central perforation not resolving with medical treatment,and 18.18% of cholestetoma in patients with attic perforation/retraction pocket,15.90% in granulation tissue and the lowest percentage of cholestetoma seen in posterior-superior marginal perforation (6.81%). conclusion: chronic suppurative otitis media with clinical markers,suspicious for underlying cholestetoma,not resolving with medical treatment,have significant percentage of presence of underlying cholestetoma. it is necessary to evaluate every patient of csom carefully for early recognition and treatment,to avoid intra and extra cranial complication.